Classifications

• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K31/00—Medicinal preparations containing organic active ingredients
  • A61K31/16—Amides, e.g. hydroxamic acids
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P17/00—Drugs for dermatological disorders
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P25/00—Drugs for disorders of the nervous system
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P29/00—Non-central analgesic, antipyretic or antiinflammatory agents, e.g. antirheumatic agents; Non-steroidal antiinflammatory drugs [NSAID]
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P35/00—Antineoplastic agents
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P37/00—Drugs for immunological or allergic disorders
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P37/00—Drugs for immunological or allergic disorders
  • A61P37/02—Immunomodulators
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P37/00—Drugs for immunological or allergic disorders
  • A61P37/02—Immunomodulators
  • A61P37/06—Immunosuppressants, e.g. drugs for graft rejection
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P43/00—Drugs for specific purposes, not provided for in groups A61P1/00-A61P41/00
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K9/00—Medicinal preparations characterised by special physical form
  • A61K9/0012—Galenical forms characterised by the site of application
  • A61K9/0043—Nose
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K9/00—Medicinal preparations characterised by special physical form
  • A61K9/0012—Galenical forms characterised by the site of application
  • A61K9/007—Pulmonary tract; Aromatherapy
  • A61K9/0073—Sprays or powders for inhalation; Aerolised or nebulised preparations generated by other means than thermal energy
  • A61K9/0075—Sprays or powders for inhalation; Aerolised or nebulised preparations generated by other means than thermal energy for inhalation via a dry powder inhaler [DPI], e.g. comprising micronized drug mixed with lactose carrier particles

Definitions

• the present invention relates to the use of 15-deoxysperguaIin for the production of an immunosuppressive, anti-inflammatory and anti-tumor drug for administration to the mucous membrane in a dosage in the range from 20 to 600 ⁇ g / kg body weight daily, in particular for the treatment of autoimmune diseases, inflammatory skin diseases, cancer diseases and to prevent graft rejection.
• the compound can be prepared either as a racemic mixture (see e.g. US-A-4 51 8 532) or in optically pure form (see e.g. EP-A-0 094 632).
• 5-deoxyspergualin is administered intravenously in a dose of approx. 4 to 6 / g / kg body weight in order to achieve an immunosuppressive effect.
• the effect is characterized by an unspecific general suppression of the immune system.
• the object of the invention is therefore to provide a preparation with few side effects for the treatment of the diseases mentioned, which is easy to use, does not develop any significant side effects even with long-term use and is therapeutically effective. Furthermore, the preparation should also be easy for the patient to use himself.
• the active ingredient DSG can be applied to the mucous membrane of the nose, the respiratory tract or other mucous membranes in the microgram range using the preferred metered dose aerosol, the single dose being determined by the amount of active ingredient per stroke (200 to 800 micrograms per stroke) is determined.
• the low and precise dosage in the microgram range makes it possible for the first time to practically achieve the pharmacological effects that can be achieved with this dosage. Local as well as systemic effects are created, since a sufficient amount of the active ingredient is absorbed and gets into the bloodstream. In the low dose range, transdermal systems are also suitable for long-term therapy.
• the invention relates to the use of 15-deoxysperguaiine or a pharmaceutically acceptable salt thereof as an active ingredient, optionally together with customary auxiliaries and carriers and / or other active ingredients for producing an immunosuppressive anti-inflammatory or anti-tumor drug in the form of a drug for application to the mucous membrane in a dosage of 20 to 600 // g / kg body mass daily preparation, preferably in the form of a metered dose.
• autoimmune diseases of every genesis and of every organ can be treated, for example myasthenia gravis, myositis, multiple sclerosis, Hashimoto's thyroiditis, athrophic gastritis, ulcerative colitis, nephrotoxic nephritis, lupus diseases, arthritis, scleroderma, granulomatosis, autoimmune myocarditis Autoimmune cytopenia, psoriasis, neurodermatitis, dermatitis herpetiformis, eczema, Graves' disease, pancreatitis, uveitis, ulceris, glomerulonephritis, rheumatoid arthritis, Alzheimer's, AIDS and the like.
• Treatment is preferred of multiple sclerosis, lupus erythematosus, virus-induced autoimmune diseases, AIDS, glomerulonephritis, psoriasis and neurodermatitis.
• Cancers that can be treated include leukemia and solid tumors, such as the lungs, breast, sarcomas, ovaries, lymphomas.
• Graft rejection reactions can occur in the transmission of any human organ or tissue. The fate of the transplant depends largely on the type and extent of the immune response in the recipient. The survival time of the transplant is considerably improved by the immunosuppression caused by the medicament obtained according to the invention.
• the active ingredient deoxyspergualin could only be administered intravenously or intramuscularly due to the high doses required.
• the invention allows the active ingredient in the low dosage according to the invention to be administered effectively by mucosal application.
• the dosage essential in the context of the invention is in the range of 20 to 600 / g / kg of body weight daily. It is preferably reliably observed in that the medicament obtained in accordance with the invention is packaged and used in a metered dose aerosol applicator, which administers a fixed amount of active substance with each actuation. If, for example, the metered dose aerosol device is set up in such a way that aerosol with a content of 500 ⁇ g of active ingredient is sprayed off with each stroke, this results in a patient with a body weight of 60 kg and a dose of 100 g / kg body weight daily per nose side overall 6 pump pulses, corresponding to 2 pump pulses per side 3 times a day.
• the daily dose is suitably administered in one to three single doses.
• the dose to be administered in each case is determined by the doctor depending on the severity of the condition to be treated, the age, Gender and weight of the patient and the duration of treatment.
• the medicament produced according to the invention is preferably formulated as an aerosol, but can also be present, for example, in the form of an ointment, a cream, drops, or a lotion which are formulated for application to the mucous membrane, in particular the nasal mucosa.
• Administration to the nasal mucosa or respiratory mucosa is preferred, e.g. in the form of a nasal spray, aerosol, nasal ointment or nasal drops, as this significantly reduces the burden on the patient and can therefore improve patient compliance. Due to the low dosage of the active ingredient, such a nasal administration is possible for the first time since the low concentrations do not cause irritation to the mucous membrane. There is also no influence on the ciliary function.
• the buccal form of administration in which the active ingredient is absorbed through the oral mucosa, is also suitable. Dosed administration of the medicament produced according to the invention is also possible via the vaginal mucosa and the intestinal mucosa, the formulation then being the usual form of preparation for these applications, e.g. as a suppository.
• the active ingredient deoxyspergualin can be packaged for use in accordance with the invention in a manner known per se and processed for pharmaceutical use.
• customary auxiliaries and carriers are used in the field of pharmaceutical formulation for the respective administration form.
• the active ingredient can be used either as a free base or as a pharmaceutically acceptable acid addition salt together with conventional carriers and other common pharmaceutical additives.
• pharmaceutically acceptable acid addition salts with organic and Inorganic acids are, for example, chlorides, hydroxides, lactates, malates, fumarates, acetates, carbonates, citrates, tartrates, glycolates etc.
• the 1 5-deoxyspergualin can be administered either as the only active ingredient or together with other active ingredients as well as vitamins, minerals and known drug additions.
• suitable further active ingredients are those with pharmacological activity, provided that they are compatible with 1 5-deoxyspergualin, e.g. Corticosteroids such as cortisone, camphor, echinacea, euphorbium etc., or active substances with a supplementary accompanying effect, e.g. Fumaric acid, active ingredients with absorption and penetration-promoting action on 1 5-deoxyspergualin, e.g. Isopropanol or propylene glycol, active substances with a caring effect, e.g. Chamomile oil, azulene, panthenol, retinol palmitate, glycerin.
• the preparation of a preparation to be administered to the mucous membrane preferably to the respiratory or nasal mucous membrane, it is possible to use all auxiliaries and carriers which are customarily used in the field of mucosal agents.
• the preparation can also take any other form that is suitable for precisely metered administration via the mucous membrane and can, for example, in the form of a nasal spray, nasal drops, nasal ointment, nasal suspension, nasal gel or the like. available.
• the usual dosage forms adapted to the administration form such as medium-chain triglycerides, peanut oil, carbonner, macrogol, wool wax, alcohol ointment base, water for injection, paraffin liquid and excipients, such as preservatives, for example benzalkonium chloride, thiomer sal, butylated hydroxytoluene, PHB esters, isotonic agents, and isotonic agents - Drug phosphate, sodium monohydrogen phosphate or sodium chloride, and flavorings and aromas, such as fennel oil, eucalyptus oil, peppermint oil, mountain pine oil, cedar leaf oil and the like, are used.
• the nasal spray can be in the form of a pump spray or in a pressure can with a pharmacologically acceptable propellant. Packaging in a metered dose aerosol container is particularly preferred.
• deoxyspergualin with magnesium is particularly preferred. It has been found that this combination is particularly well tolerated. Magnesium reliably prevents the (rarely) occurring subjective complaints (e.g. dysesthesia) during treatment with 1 5-deoxyspergualin.
• a nasal spray is produced in a manner known per se.
• the application is carried out according to the instructions of the doctor.
• Example 3 Ointment 10 mg of 1 5-deoxyspergualin and 50 g of Eucerin are mixed with customary auxiliaries and additives and processed to form an ointment. The ointment is applied to the mucous membrane several times a day.
• Example 4 Ointment
• 1 0 mg 1 5-deoxyspergualin are processed with 50 g of purified petroleum jelly, essential oils and azulene in a manner known per se to form an ointment.
• the ointment is applied to the mucous membrane several times a day.
• Example 5 Ointment 10 mg 1 5-deoxyspergualin are processed with 50 g Eucerin and 1.0 g fumaric acid, optionally with the addition of fragrances and preservatives, to form an ointment. The ointment is applied to the mucous membrane several times a day.
• deoxyspergualin 250 mg deoxyspergualin are processed with Paraffinum liquidum, benzalkonium chloride and sodium citrate to 10 ml nasal oil in a manner known per se.
• the nasal oil is applied to the nose according to the doctor's dose instructions.
• deoxyspergualin 20 mg deoxyspergualin are processed with 2 mmol magnesium chloride and 100 ml purified water, optionally with the addition of chamomile flower fluid extract, in a manner known per se to give nose drops.
• the dosage is done according to the instructions of the doctor.
• deoxyspergualin 50 mg deoxyspergualin are mixed with ethyl acetate, sorbitan trioleate, dichlorodifluoromethane and trichlorofluoromethane to form a metered dose aerosol 200 single cans processed. Dosing is done according to the doctor's instructions.
• Patient 1 female, 31 years, 60 kg body weight, MS diagnosis 1 989 by clinic, magnetic resonance imaging and detection of oligoclonal bands in the cerebrospinal fluid, since then approx. 2 relapses per year, slowly increasing disability, presentation 8/1 994, walking distance approx. 1 00 m with stick, light paraspastic, dysesthesia, retired for 1 2 months.
• Patient 2 male, 25 years, 81 kg body weight, MS diagnosis 1 992 by clinic, magnetic resonance imaging and detection of oligoclonal bands in the cerebrospinal fluid, since then approx. 4 relapses per year, slowly increasing disability, presentation 7/1 995, walking distance approx. 50 m, ataxia, atactic-spastic gait pattern, severe fatigue.
• Patient 1 male, 29 years, 65 kg, MS diagnosis 1 991 by clinic, magnetic resonance imaging and oligoclonal bands in the cerebrospinal fluid, presentation 3/1 996, walking distance approx. 100 m, spastic-atactic gait pattern, disturbed fine motor skills, severe fatigue, Inability to work (student).
• Patient 2 female, 41 years, 57 kg, MS diagnosis 1 987 by clinic, magnetic resonance imaging and oligoclonal bands in the cerebrospinal fluid, presentation 5/1 996, chronic fatigue, walking distance approx. 1 50 m, spastic-atactic gait pattern, strength of the hands significantly reduced, slight ataxia of the hands.
• Example 1 Treatment of Lupus Erythematosus a. Lupus erythematosus (LE), cutaneous form
• Patient male, 1 2 years, 40 kg, diagnosis 1 995 by skin biopsy and clinic, presentation 7/96, numerous skin spots and lesions all over the body, previous therapy 40 mg decortin / day, chronic fatigue.
• Patient male, 1 6 years, 42 kg, diagnosis 1 989 by clinic and laboratory tests, presentation 7/1 994, nephrotic syndrome with high protein loss (7.5 g / l) from the kidney, butterfly erythema on the face, chronic fatigue, school attendance not possible for 2 years.
• Patient male, 29 years, 74 kg, diagnosis 1 995 by kidney biopsy, chronic fatigue, presentation 1 1/1 995, fatigue, increased creatinine (1, 9 mg), fluid retention.
• Patient male, 36 years, 79 kg, diagnosis 1 987 by clinic and positive rheumatoid factor, presentation 6/1 996, chronic fatigue, painful, restricted movement in the finger, knee and shoulder joints.
• Patient male, 1 0 years, 22 kg with neurodermatitis, diagnosis 1 990, presentation 8/95, painful, itchy areas of the skin on the trunk and on the extremities, improvement with cortisone ointment.
• Patient male, 1 9 years, ALL, diagnosis 1 995 secured by clinic, blood count, immunohistochemistry and BM puncture, presentation 5/1 996.

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• Health & Medical Sciences (AREA)
• Public Health (AREA)
• Pharmacology & Pharmacy (AREA)
• General Health & Medical Sciences (AREA)
• Chemical & Material Sciences (AREA)
• Veterinary Medicine (AREA)
• Animal Behavior & Ethology (AREA)
• Medicinal Chemistry (AREA)
• Life Sciences & Earth Sciences (AREA)
• Chemical Kinetics & Catalysis (AREA)
• Organic Chemistry (AREA)
• Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
• General Chemical & Material Sciences (AREA)
• Engineering & Computer Science (AREA)
• Bioinformatics & Cheminformatics (AREA)
• Immunology (AREA)
• Epidemiology (AREA)
• Neurology (AREA)
• Rheumatology (AREA)
• Biomedical Technology (AREA)
• Pain & Pain Management (AREA)
• Neurosurgery (AREA)
• Transplantation (AREA)
• Dermatology (AREA)
• Medicinal Preparation (AREA)
• Acyclic And Carbocyclic Compounds In Medicinal Compositions (AREA)
• Pharmaceuticals Containing Other Organic And Inorganic Compounds (AREA)
• Medicines That Contain Protein Lipid Enzymes And Other Medicines (AREA)

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• 1997
  • 1997-07-03 DE DE19728436A patent/DE19728436A1/de not_active Ceased
• 1998
  • 1998-06-26 DE DE19880842T patent/DE19880842D2/de not_active Ceased
  • 1998-06-26 HU HU0003038A patent/HUP0003038A3/hu unknown
  • 1998-06-26 US US09/446,896 patent/US6166087A/en not_active Expired - Fee Related
  • 1998-06-26 PL PL98337802A patent/PL337802A1/xx unknown
  • 1998-06-26 EP EP98939540A patent/EP1001753A1/de not_active Withdrawn
  • 1998-06-26 TR TR1999/03322T patent/TR199903322T2/xx unknown
  • 1998-06-26 JP JP50628699A patent/JP2002507221A/ja active Pending
  • 1998-06-26 CA CA002294785A patent/CA2294785A1/en not_active Abandoned
  • 1998-06-26 WO PCT/EP1998/003927 patent/WO1999001123A1/de not_active Application Discontinuation
  • 1998-06-26 AU AU88014/98A patent/AU8801498A/en not_active Abandoned

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